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Medical school to benefit from stimulated budget at the NIH

The School of Medicine recently submitted its latest wave of grant proposals to the National Institutes of Health (NIH), capping off a financially turbulent semester on a high note and easing concerns that had caused a contentious divide between faculty and administrators there just a few months ago.

Specifically, faculty on the Boston campus are hoping that a revitalized budget at the NIH will mitigate the effect of a new salary plan that ties pay rates to grants; the federal stimulus bill has added $10.4 billion to the institutes' coffers.

The plan, which was announced in December and will take effect July 1, dictates that tenured faculty members at the medical school who do not bring in 15 percent of their salaries through grants will take a 25-percent pay cut.

The new model has drawn significant criticism from the school's professors, who have chastised the administration for not adequately consulting with them and have called the change an attack on the economic principle of tenure.

But now the professors are hopeful that the concerns that ignited tensions earlier in the semester will become virtually moot, as the new funding situation has likely prevented all but one of them from being impacted.

"What we're honestly hoping is that a rising tide will lift all boats," Professor of Anatomy John Castellot, the chair of the medical school's Faculty Senate, said. "We're hoping that … within a short time, everyone will be out of danger of a salary cut."

Shifting currents

Meanwhile, Castellot and other members of the Senate, a group that represents the concerns of the faculty, are celebrating a renewed partnership with administrators as they cooperate to redefine the school's funding model.

They are looking to adapt to shifting currents on the national level, where medical schools are increasingly suffering in the ailing economy.

On the one hand, students' financial troubles have left the schools unable to adequately raise tuition, while on the other, resource shortages are plaguing hospitals.

The challenges that hospitals are facing are particularly relevant to medical schools, many of which depend heavily on teaching hospitals like Tufts Medical Center.

As such, university administrators nationwide have their eyes turned to Washington in the hopes that the federal government can fix what they consider to be broken insurance and health-care systems.

"At the moment, we are managing adequately by being lean and by being innovative," Provost and Senior Vice President Jamshed Bharucha said of Tufts' medical school. "But in the end, the shortage of primary-care physicians and the rising health-care costs can only be solved by action at the federal level."

In the meantime, though, being lean has come at a cost. The medical school, for example, eliminated 11 staff positions earlier this semester.

Still, faculty and administrators are cooperating to try to find solutions that save money without necessitating sacrifices.

"We're open to all suggestions about innovations that would help us address some of these issues, and so we're engaged with the faculty about conversations about innovation," Bharucha said. "This is a process. We're not there yet."

A key piece of the puzzle may be departmental reorganization. Currently, the school's Strategic Goals Implementation Committee is examining proposals that range from completely eliminating the concept of departments to merging some that have similar focuses.

The committee, which is a collaborative effort between the faculty and the administration, is currently in the midst of considering the options, according to Castellot, who is a member. No final decisions have been made, he said.

Castellot said that the committee is not looking to cut any positions, and instead is focusing on maximizing the school's resources and making it more attractive to prospective students.

Still, it is unclear if the committee will even suggest any alterations at all. "There's no directive that we have to change," Castellot said. "So a very possible outcome of the committee's work is to recommend that the department structure remain the same."

A stimulated NIH

Despite the school's efforts to become more efficient, perhaps the biggest boost was something entirely outside of the administration's control: the burgeoning NIH budget.

Before the passage of the stimulus bill, the NIH, which accounts for the majority of the medical school's grants, had been suffering from substantial financial difficulties.

"We have been living in an economically depressed environment," Professor of Physiology Ira Herman, a former chair of the Faculty Senate, said. "[The] NIH has been struggling through the Gulf War years and the Bush administration."

As an indication of this trend, the NIH accepted around 25 percent of grant proposals in 2001, compared to about 10 percent in 2008, according to Castellot.

"This has put a huge financial burden on the medical school, which depends on its faculty to get grants," he said.

School of Medicine Dean Michael Rosenblatt said the situation has been particularly bad in the past five years and has hurt universities across the country.

"Almost all research-based medical schools in the U.S. entered this economic downturn already facing financial challenges because NIH funding was flat to decreased over the last 5-year period," he said in an e-mail. "No school or university is immune to the consequences of the global economic environment."

It was in that environment that the medical school enacted the new salary plan.

"When the financial crisis hit, it was necessary for us to make some very tough decisions," Bharucha said.

Part of that, he said, meant pressuring the faculty to bring in more grants, which come with direct funds for the university and reduce the amount that Tufts needs to contribute to salaries.

When faculty members receive grants, a portion goes to overhead for research, the university receives a chunk, and the rest is direct compensation that counts as part of their salaries.

Typically, although it was never formalized, the expectation had been that the medical school would pay 40 to 50 percent of professors' salaries, and that the professors would bring in the rest through grants. When they failed to do so, the school would pick up the tab.

As such, the new 15-percent requirement, which takes into account a three-year rolling average of faculty members' grant contributions, was not considered particularly high, even though before the stimulus, around five or six professors were in jeopardy of receiving cuts.

Since there are only around 44 tenured faculty members at the medical school, excluding the department chairs who were involved in crafting the new plan, the change would have had a substantial impact.

"Thankfully, we're all grateful that it's not turning out to be a large number this year, but it was initially over 10 percent of the tenured faculty this year and projected to grow to around 30 percent over the next several years if the NIH budget didn't recover," Castellot said.

Still, professors are not yet completely out of danger, since the stimulus funds will only help the NIH for at most two years. After that, Castellot hopes that the government will continue to provide the institutes with adequate funding.

"The stimulus package is a short-term but not a long-term solution," he said.

Closing the rift

Beyond the economic aspects, professors also raised objections about the spirit of the new salary plan. In particular, according to Castellot, they felt that they had been left out of the decision-making process.

"Almost all the faculty — more than 90 percent of the faculty — felt that there had not been sufficient consultation by the administration [with] the rank-and-file faculty before imposing a salary plan that was fundamentally different from the one we had before," he said, noting that professors were "quite upset."

This touched off a dispute between the faculty and the administration, which culminated in two faculty petitions reaching the Board of Trustees. One objected to the plan itself, while the other raised questions about the lack of consultation.

Castellot said administrators took the faculty's misgivings seriously, but have not shown any intention of backing away from the plan.

"It's a done deal. There's nothing we can do about it. We had hoped that by expressing our concerns in the strongest way possible … we might be able to convince the senior administration to find a different plan," Castellot said. "But we failed in that, and we have to move on."

In doing so, Castellot said that there is no ill will between the faculty and the administration. "This is a situation where people don't see eye to eye but are still working collegially and expeditiously to try to make the best of a bad economic situation," he said.